Following publication of a recent article in JAMA Ophthalmology, one of the senior editors appropriately asked me if the article “abbreviations gone wild.” The inquiry was not as easy as asking if articles should use the abbreviations RE and LE vs OD and OS. (As an aside, I personally prefer writing out right eye or left eye, or if necessary using RE or LE, but avoiding the use of OD or OS since nonophthalmologists do not readily understand that OD is oculus dexter, or even if they did know that oculus dexter is Latin for right eye.)

The senior editor’s inquiry was regarding some of the abbreviations that had made their way into recent JAMA Ophthalmology articles, which, when taken out of context, might be difficult for most readers to understand. This included abbreviations like CDI (capillary density index), FD (fractal dimension), SVP (superficial vascular plexus), or DVP (deep vascular plexus). Additional abbreviations in the same article seemed appropriate for the peer-reviewed ophthalmic literature, such as DME (diabetic macular edema) and PDR (proliferative diabetic retinopathy) or even the general medical, not specifically nonophthalmic, abbreviation of HbA1c (which could be considered an abbreviation for hemoglobin A1c or glycated hemoglobin or A1c).

The journal’s instructions for authors indicate that authors generally should not use abbreviations in the title, subtitle, or abstract unless these sections include the name of a group that is best known by its acronym. For example, it might have been easier to understand a title that says, “Single-Nucleotide Polymorphisms Associated With Age-Related Macular Degeneration and Lesion Phenotypes in CATT”, although the copy editors, perhaps concerned that readers might not know what CATT stood for, preferred, “Single-Nucleotide Polymorphisms Associated With Age-Related Macular Degeneration and Lesion Phenotypes in the Comparison of Age-Related Macular Degeneration Treatments Trials.”

Instructions to authors also indicate that authors should expand all abbreviations at first mention in the text. Fair enough. The CATT article mentioned above used only a few abbreviations, judged likely to be understood by most readers, including SNPs (single-nucleotide polymorphisms), CNV (choroidal neovascularization), and AMD (age-related macular degeneration). But even assuming that authors (and copy editors) remember to expand all abbreviations at first mention in text, how does one balance the desire to simplify and facilitate language in the medical literature with the risk that a reader may get lost in understanding an article due to overuse of nonstandard abbreviations?

Within medical practice, as electronic medical records become more readily available to physicians and others outside of the field of ophthalmology, there is greater emphasis on avoiding abbreviations to avoid any ambiguity that might contribute to a medical error. For the medical literature, though, it seems appropriate at this time to consider a balance between the convenience and clarify of common abbreviations, while avoiding uncommon abbreviations that could make it difficult to understand what is written, or even worse, misinterpret what is written.

How will this balance be achieved? Senior editors and copy editors should continue to scrutinize the use of abbreviations and ask whether it is more appropriate to abbreviate (to facilitate clarity of a sentence) or spell out the phrase (to avoid failure to understand the sentence). While 20 years ago “OCT” might have meant “October” to the ophthalmologist, a transition has occurred wherein the use of OCT seems totally appropriate when discussing optical coherence tomography. And while OCT angiography is working its way into readily recognition of OCT-A (or should it be OCTA?), only time will tell what abbreviations of today follow the path of ICCE (intracapsular cataract extraction) tomorrow.

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